HardEndocrinologyChronic kidney disease in type 2 diabetesuk-plab-1
A 64 year old man with long standing type 2 diabetes and hypertension is found on annual review to have an estimated glomerular filtration rate of 42 mL per minute per 1.73 m2 and an albumin creatinine ratio of 45 mg per mmol. He is already on maximum tolerated Ramipril. According to current NICE guidance, which additional class of drug should be considered to reduce his risk of progression of chronic kidney disease and cardiovascular disease?